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Differential efficacy of empirical antibiotic therapy for febrile neutropenia in adolescent/young adult (AYA) and child patients

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Abstract

Survival rates in adolescent/young adult (AYA) patients with malignant diseases have improved with the introduction of pediatric-type chemotherapy; however, the higher frequency of treatment-related complications, including infections, remains a major challenge. We hypothesized that the efficacy of antibiotics may differ between AYA and younger children. We aimed to evaluate differences in the efficacy of antibiotics between them by retrospectively analyzing patients registered in previous first-line antibiotic comparative studies on febrile neutropenia (FN). Patients were classified into two groups: patients younger than 15 years of age (children group) and those aged 15 years or older (AYA group). The efficacy of antibiotic therapy was compared between groups. Success of therapy was defined as resolution of febrile episodes and clinical signs of infection within 120 h of the initiation of antibiotic therapy. A total of 818 febrile episodes in 204 patients were analyzed. Antibiotic therapy success rates were lower in the AYA group than in the children group (53.8 vs. 63.7%, P = 0.028), even when patients were restricted to those with bacteremia (11.8 vs. 41.4%, P = 0.025). However, mortality rates did not differ (0 vs. 0.5%, P = 1.000). The efficacy of first-line antibiotic therapy for FN was poorer in AYA patients than in child patients.

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Authors and Affiliations

  1. Department of Hematology/Oncology for Children and Adolescents, Sapporo Hokuyu Hospital, Higashi-Sapporo 6-6, Shiroishi-ku, Sapporo, 003-0006, Japan

    Hirozumi Sano, Ryoji Kobayashi, Daisuke Suzuki, Kenji Kishimoto, Daiki Hori, Satoru Matsushima & Kunihiko Kobayashi

  2. Department of Pediatrics, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1-1, Asahikawa, 078-8510, Japan

    Makoto Yoshida, Takeo Sarashina & Naohisa Toriumi

Authors
  1. Hirozumi Sano
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  2. Ryoji Kobayashi
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  3. Daisuke Suzuki
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  4. Kenji Kishimoto
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  5. Daiki Hori
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  6. Satoru Matsushima
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  7. Makoto Yoshida
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  8. Takeo Sarashina
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  9. Naohisa Toriumi
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  10. Kunihiko Kobayashi
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Contributions

HS, RK, and KK planned the study, interpreted the data, and wrote the manuscript. DS, KK, DH, SM, MY, TS, and NT helped with data collection and interpretation.

Corresponding author

Correspondence to Hirozumi Sano.

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The authors have no conflicts of interest to declare.

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Sano, H., Kobayashi, R., Suzuki, D. et al. Differential efficacy of empirical antibiotic therapy for febrile neutropenia in adolescent/young adult (AYA) and child patients. Int J Hematol 108, 543–549 (2018). https://doi.org/10.1007/s12185-018-2503-6

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  • DOI: https://doi.org/10.1007/s12185-018-2503-6

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